ptsd 100% Schedular Ptsd No Longer Awarded?

[vasolas]

Please forgive my long-windedness but I'd really appreciate your advice, thoughts and opinions also I guess this is letting off steam for me.

I'm a Vietnam infantry vet and I served as a spotter on a sniper team. I've had about 16 years of intermittent private psychotherapy and continuous VA treatment since 2001. My ptsd claim included an '05 "PTSD Evaluation" from a private psychologist that I've seen weekly for almost 9 years. (it was very detailed but I'm only outlining here) It noted that I had chronic suicidal ideation, homocidal thoughts and that I was a risk to do harm to myself or others. It diagnosed ptsd chronic, severe and major depression, recurrent. It noted that I was medically retired due to ptsd and stated that, due to ptsd, I was totally and permanently disabled, unemployable and unlikely to improve. It assigned a GAF of 30. Also I had included supportive reports from a private social worker, psychiatrist, and former employer that documented my treatment for ptsd going back to 1990 as well as more recent progress notes from my VA hospital.

The VA C&P psychiatrist diagnosed chronic ptsd & major depression recurrent and severe. His report described me as a "hermit" who is "severely impaired socially and vocationally". He wrote that "It is unlikely that this man could ever function in any kind of work capacity at this time". He assigned a GAF of 35.

I'd expected to be awarded 100% schedular ptsd but in June 05 I received 70% and IU was deferred. I filed a NOD with a personal narrative that described how my symptoms had worsened and how they approximated the General Rating Formula for Mental Disorder's criteria for 100% schedular disability. Included was a copy of my recent SSD award due to ptsd, a progress note from a VA psychiatrist that stated that I was "considered totally and permanently disabled for gainful employment", 3 more progress notes all with GAF's of 30, plus other supportive documentation.

In late March 07 I received a SOC that continued my 70% and ignored most of my evidence that supported a grant of 100% schedular. It cited 9 pages of VA regs and 1 of reasons and bases. The R&B's described me as having mild to moderate daily dysphoria, moderate social anxiety symptoms (I've been a hermit for years inorder to cope with severe anxiety,depression and to avoid conflict with people), no violence toward people (my personal narrative described one of several such incidents in which I had crawled with loaded weapon to a car that had stopped at night in the boonies where I live - my VA psychiatrist hadn't quoted this incident directly in his report but had referred to it as an example of my "perpetual combat behaviors"). The SOC also stated that I denied suicidal or homocidal ideations (the preponderance of the many documents I'd sent noted chronic suicidal thoughts (w/o intent) and at least 2 of them reported homocidal thoughts). The SOC selectively plucked from the many documents I'd sent any positive reference to myself and ignored the statements that were supportive of a 100% schedular rating. For example, It used against me one sentence from a report that noted that I had helped to care for my terminally ill father but it made no reference to my occupational impairment, my consistenly low GAF scores and I was not offered another C&P.

I would greatly appreciate any advice, thoughts or opinions about my case and how I might best present my appeal for 100% schedular to the Board (my deadline is near). Perhaps I should be satisfied with 70% and the possibility of IU especially since so many deserving vets aren't even awarded that, and I know that it is now very difficult or perhaps impossible to be granted 100% schedular, but it is a matter of principal to me since I believe that my war-related mental disorder has rendered me 100% disabled.

Also is it possible/likely that VARO will deny me IU when I apply or order me to a C&P for IU? If it is awarded would it be retroactive to my original claim date-June 05?

Incidentally, I believe my claim for 100% schedular would have been granted 6-10 years ago despite the requirement of having psychotic symptoms per the General Rating Formula. I'm aware that VA has been criticised for spending so much and awarding so many 100% schedular awards in the past but I'm not aware of any published documents that have directed VA to limit granting such awards. Does anyone know of such directives or of any VA watchdog who has revealed them?

Does anyone know of anyone who has received 100% schedular ptsd in the past year and of the basis for that award?

Has the VA completely stopped awarding 100% schedular for ptsd?

[jbasser]

Vasolas, just get your doc to write a note that you are not able to work due to your SC PTSD. You can have a Denoveau review of the file at the RO. You should win this one at appeal.

[Vike17]

Vasolas,

You said in June 2005 you were awarded 70% but IU was deferred. Have you received a a decision on that issue yet?? It's going on two years and that is an awfully long time for a deferred claim to still be pending. Another thing I noticed is that you received a SOC in March 2007, probably due to the NOD you submitted. Normally, the VA will decided any issues/claims that are still open before they will work an appeal, thus leading me to either think they decided your IU claim somewhere in beteween June 2005 and March 2007, or they dropped the ball and haven't addressed that issue yet. Also, depending on what day in March you received the SOC, your 60 days to submit any "new" evidence or VA Form 9 to "prefect" your appeal is running REALLY short. So please keep this in mind!!

If the VA did drop the ball and somehow forget your deferred IU claim, the effective date is still the date you originally submitted the VA Form 21-8940. So you won't loose any retro if this is the case. As far as a C&P exam, the VA will proabably set you up with one since it has been over a year since your last one.

I did notice you also said;

"Also is it possible/likely that VARO will deny me IU when I apply or order me to a C&P for IU? If it is awarded would it be retroactive to my original claim date-June 05?"

Did you even apply (send in VA Form 21-8940) for IU???? If you didn't apply for it, the VA could in your case "infer" the issue of IU because you meet the schedular requirements of IU AND your records reflect you are currently unemployed due to your srevice-connected PTSD. However, if the VA still inferred the issue of IU, you still need to submit VA Form 21-8940 so they can continue to process the claim.

Did you request a DRO review in yor NOD?? Did you have a hearing with a DRO to personally present your case?? These two could have certainly helped your case out. If you didn't have a DRO review of your claim, then you passed up a chance to have a more experienced rater look at your claim with a set of 'fresh eyes." Your only option now since that you have received a SOC is to either submit "new" evidence and wait for either a grant in benefits sought or a SSOC, or perfect your appeal by sending in the Form 9 and have your case go to the BVA. Based on the information you posted, a DRO probably would have overturned the prior decision and awarded 100% schedular.

"Incidentally, I believe my claim for 100% schedular would have been granted 6-10 years ago despite the requirement of having psychotic symptoms per the General Rating Formula"

Why didn't you apply 6 to 10 years ago??

Oh, by the way, this may be hard for you to believe with the sutuation you're in but your question;

"I'm aware that VA has been criticised for spending so much and awarding so many 100% schedular awards in the past but I'm not aware of any published documents that have directed VA to limit granting such awards. Does anyone know of such directives or of any VA watchdog who has revealed them?"

there isn't any such directive. The amount of money granted for disability compensation does not have an affect on any disability award. Now some will swear on a stack of bibles that there is a conspiracy by VA to low-ball veterans' claims or outright deny and dely claims, but the simple truth is these are just common myths about VA and hold no water.

Vike 17

[john999]

It is not the diagnosis that counts for a higher rating but the symptoms. If you have manic depression but you are able to work you will not get as high a rating as someone who has agoraphobia and is unable to leave the house. If you have schizophrenia but are able to do yard work for money you will not be rated as high as someone with OCD who can't keep a job because of symptoms even though the OCD is a neurosis and the schizophrenia is a pyschosis. With mental disorders it is all about being able to work.

[carlie]

Army,

You posted,

"They will not and cannot justify a higher award without additional paperwork."

May we agree to use the word evidence here instead of paperwork ----- because

most of us already have or had a boatload of paperwork --- a vet needs the right evidence,

EVIDENCE WINS CLAIMS.

jmho,

carlie

[Jay Johnson]

Funny, from the director of the Seattle RO, "The VA has been a bit liberal, of late, in granting 100% for PTSD and many 100% ratings should be 70% or lower." (in response to why they attempted to lower my wife from 100% to 70%). Furthermore, a friend of mine in the Oregon RO (schedules and works with BVA for that RO...or did, until he retired a few years ago) had told me, "with all of the vets coming back from iraq, the ROs are cracking down on PTSD cases".

To boot, we have an independent commission which, in effect, said that the VA is not properly rating PTSD cases. On top of that, the VA's own regs, on this matter, are clearly being violated here and in most cases. Stop apologizing for them.

As a side note - What enables the VA to low-ball PTSD claims (aside from vets working against vets) is that PTSD is episodic in nature. Now, the VA is "supposed" to take the veteran's low points and assess how often those low points occur; instead, they cherry pick the high points and use it as a basis to brow beat the veteran into a lower claim. I've seen this happen in almost every PTSD claim I've ever seen, including my wife's. It's a horrible, inhuman tactic with the expressed purpose of low-balling veteran's with PTSD.

John’s opinion on this is exactly the problem stated above and shows just how much we’ve allowed the VA to beat PTSD vets down. Just because a veteran can do yard work (or any other periodic work, including seasonal paid work) is NOT a basis for a lower rating. PTSD is fraught with highs and lows and most PTSD vets are able to do such things from time to time. The VA “should” be looking into how often the vet relapses into severe depression/anxiety/etc and THEN figure out whether reasonable employment is likely. A veteran that relapses even once every 6 month is NOT going to be able to maintain gainful employment….no employer is going to let an employee take a week or two off every 6 months because they’re anxious/depressed/angry etc.

Anything under a 40 GAF is total occupational disability by DSM standards, which should qualify any veteran for IU, but the VA often ignores GAF scores and/or takes only the highest GAF on record into account. This is a blatant, and intentional, disregard for a veteran’s condition and no psychiatrist on the planet would think otherwise.

P.S. – My current psych professor used to work for the VA. He quit to teach because he was, “sick of working for them….there was constant pressure to word things in ways to keep claims low and they would often ask me for opinions about patients that I’ve never seen, nor had any business diagnosing……..they just wanted my signature in order to deny a claim”. I’m sure this isn’t the case in every RO, but it happens and happens often (this guy worked in two separate ROs in his time working for the VA).

[Testvet]

I was awarded 100% P&T for PTSD on April 3 2006 with an effective date of Dec 2003, this was after a three year battle where they first awarded 50% for PTSD and denied all other issues, I filed an appeal and after a few more letters and lies they granted the PTSD claims and lied again and closed all the other issues again, they are all on appeal yet they can't produce the document they claim I signed agreeing to a "let's make a deal" game that I never agreed to. Let the BVA figure it out. I had three years of GAF's in the 30-40 range and 2 annual statements "that this veteran is totally and permanently disabled just by the symptoms of his PTSD, despite the other medical issues he is dealing with, it is my opinion that due to his PTSD he will never be employable again considering he has been living with PTSD for three decades and it is only deteriorating". This was done by the Chief of Clinic in Augusta Ga, and is a psychiatrist, not a pyschologist.